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NPI Code Detail

MEDICARE: LYNNETTE DIANE SPENCER LYNNETTE SPENCER MFT

MEDICARE:   LYNNETTE DIANE SPENCER  LYNNETTE SPENCER MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist43271CA

General Provider Information

NPI Number : 1649402645
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNNETTE DIANE SPENCER LYNNETTE SPENCER MFT
Provider Business Mailing Address
First Line : 2712 CRESTVIEW DR
Second Line :
City : PLACERVILLE
State : CA
Zip : 95667-3407
Country : US
Telephone Number : 530-318-1858
Fax Number :
Provider Business Practice Location Address
First Line : 2712 CRESTVIEW DR
Second Line :
City : PLACERVILLE
State : CA
Zip : 95667-3407
Country : US
Telephone Number : 530-318-1858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2009
Last Update Date : 02/20/2026

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Directions to “ LYNNETTE DIANE SPENCER LYNNETTE SPENCER MFT” Practice Location

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